Life-threatening Haemoperitoneum from a Simple Ovarian Cyst

Abstract

Ovarian enlargement of non-neoplastic origin is due to the accumulation of fluid in the functional unit. Follicular cysts are the most common physiological functional ovarian cysts. Definitive diagnosis is often difficult to establish as the clinical symptoms may be similar to acute appendicitis, acute cholecystitis, ovarian torsion or ectopic pregnancy. Spontaneous hemoperitoneum secondary to follicular cysts are rare but may be life-threatening. The case: The following case study is of a 20 year old female who presented to the emergency ward with severe right lower abdominal pain. On pelvic ultrasound a thick-walled cystic space occupying lesion (SOL) of size 70mm x 56mm was noted in the right side with peripheral vascularity and peripheral tiny follicles. Mild to moderate ascites was also seen. An emergency laparotomy was performed. The histopathology of the ovarian cyst was reported as follicular cyst with no evidence of malignancy. Conclusion: This case study emphasizes the optimal management of ruptured ovarian cyst and the elimination of differential diagnoses.